Life is Beautiful

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What is collagen?

Collagen is a protein that is necessary for almost every bodily function.  it helps build and maintain bones,  teeth, gums, and tissue, amongst other things.  Collagen consists of 19 amino acids and 28 proteins.  It comprises 30% of the body’s protein (Borumand & Sibilla, 2015) and makes up 90% of bone matrix proteins, otherwise known as  the scaffolding for bone formation  (Dept. Washington Education).

Regarding aging, collagen supplementation is important as, after age 25, people  produce 1%  less each year (Wright, 2014).  Further, collagen (and gelatin, made from collagen) contains high concentrations of glycine and proline, amino acids that are often deficient in the western diet (PDB-101).  Collagen supplements both  increase collagen in the body and slow down a process known as enzyme collagenase, or the break down of collagen between cells (Human Clinicals).

There are several types of collagen in the body (type I being the most prevalent) and at least four available to purchase as supplements.  Collagen is important to aging as the body’s ability to make it declines with age and it is necessary for health.  Women especially have a hard time producing it after menopause. Post-menopausal women may experience up to a 75% drop in the production of type I collagen (which has types III & V in it).  This effects women in a variety of ways.  Women can experience hormonal changes associate with peri-menopause.  The sex hormone estrogen increases the amount of collagen in skin, influences skin thickness, and its moister content (Verdier-Sevrain, Bonte & Gilchrest, 2006).  During the menopause transition collagen under skin (fatty tissue and protein) is lost (National Institute on Aging).

Life style factors that impact collagen production negatively are: diets high in sugar, too much sun, excessive alcohol use, smoking, and nutritional deficiencies, (collagen depleted diets) and digestive problems (Axe, 2015).

Different types of collagen have different amounts of amino acids in them.  Having said that, both bovine and fish collagen usually have the following amino acid content:  alanine, arginine, aspartic acid, cysteine, glutamic acid (glutamine), glycine, histidine, hydroxylysine, hydroxyproline, isoleucine, leucine, lysine, methionine, phenylalanine, proline, serine, threonine, tyrosine, & valine (Szpak, 2011).

Amino acids present in of special note:

Arginine (L-arginine): helps with heart and artery problems/health and is important for circulation.  Arginine also improves the male sex drive and can strengthen the immune system (Axe, 2015).  It can help burn fat (Marimee et al, 1965), heal wounds and helps in weight-reduction.  Arginine also helps to lower cholesterol.  Regarding  how it helps lower blood pressure and improve circulation:  arginine releases nitric oxide into the blood, this then relaxes the blood vessel walls and improves circulation.  This  can then improves the elasticity of the arteries, lowering blood pressure.   This is why arginine, over time, helps improve erections, potency, stamina and sexual performance (Williams et al, 2002).

Arginine helps with hair growth (Wu, Meininger, Knabe, Baze, & Rhoads, 2000).

Arginine helps reduce insulin resistance and improves glucose tolerance and insulin sensitivity in type 2 diabetes, lowering the amount of insulin needed (Piatti et al, 2001).

Arginine, along with ornithine, and glutamine, can help sleep by detoxifying ammonia, which if the liver is not working properly, will build up and reach the brain, causing insomnia (Lavie, Hafetz, Luboshitzky, & Lavie, 2003).

Arginine supports bone health by assisting in the production of collagen and by helping osteoblasts (forms bone mass) develop. Arginine deficiency in women is linked to osteoporosis (Ammanne et all 2002).

Glycine is a semi-essential amino acid is present in collagen (29%) and protein.  Glycine is often not properly provided for in the modern diet, leading to a need for supplementation (Melendez-Hevia, De Paz-Lugo, Cornish-Bowden, & Cardenas, 2009).   Glycine builds DNA, forms creatine (needed for muscle growth/maintenance; energy production).   It is necessary for a healthy metabolism. Glycine inhibits neurons in the brain that produce  norepinephrine  (Hospital News), which is associated with anxiety (Pervose et al, 2001).  Obsessive compulsive disorder: The appropriate dose of glycine has been shown to be an effective treatment for obsessive compulsive disorder (OCD) as well as Body Dysmorphic Disorder (BDD) in some people.   This is as it is believed that these disorders are caused by a receptor in the brain failing to work properly (Cleveland, DelaPaz, Fawwaz, & Challop, 2009).  It is called N-methyl-D-aspartate (NMDA).  It is considered to be very important for memory function and learning as well as and brain plasticity or growth (Li, F., & Tsien, J.Z., 2009). Glycine makes the NMDA receptor work.

Glutamine: prevents anxiety, insomnia/sleep problems, tension, improves concentration, increases energy levels and helps digestion and strengthens immunity.  It helps with wound healing and joint health.  Glutamine even helps produce human growth hormone, this helps with maintaining mental well being as it helps release GABA to boost feelings of calm and tranquility (Welbourne, 1995). Some psychiatric drugs (benzodiazepines and barbiturates) are used to increase the brains production of GABA to boost feelings of calm and wellbeing (Purves et al., 2001).

Hydroxyproline: is 30% higher in bovine collagen then in fish collagen (Gauza-Wlodarczyk, Kubisz, & Wlodarczyk, 2017).  This amino acid, along with proline, help hair to grow.

Phenylalanine helps nerve cells communicate and is necessary for the central nervous system to function properly.  It also supports memory functioning.  Phenylalanine helps with pain management in chronic and acute pain associated with cramps, arthritis and migraine headache.

Phenylalanine is converted into phenylethylamine (PEA) in the body (Nootriment). This is considered a natural “love drug” and is associated with infatuation, sexual desire and the sex drive. PEA also boosts dopamine, a neurotransmitter associated with feelings of pleasure, sexuality, and the brains reward system overall.  This is why dopamine helps with feelings of wellbeing, with treating depression and lessoning anxiety.  Phenylalanine (PEA) also helps the brain release norepinephrine, which can help with attention span, motivation, productivity and cognitive (thought based) performance (Nootriment). It also can increase heart rate and is associated with the so-called fight or flight response (Nootriment).

Phenylalanine is also converted into L-Tyrosine. This amino acid, when available in food sources, does not   cross the blood brain barrier, so it is necessary to consume foods that have the building blocks of this amino acid.  L-Tyrosine keeps cell membranes healthy and helps make biochemical messengers that allow the cells to communicate.  L-Tyrosine increases dopamine production and helps with norepinephrine reuptake.  By helping to balance dopamine and norepinephrine.  L-Tyrosine supports communication between different areas of the brain; it also keeps neural hormones balanced, optimizes energy and supports metabolism (Nootriment).

Proline is an amino acid present in collagen (15%).  Protects blood vessels and heart health, helps joints health.

Sources of collagen: Head cheese, pig feet, chicken feet, hard boiled eggs, Oxtail, Veal and Lamb, 6 to 7 cups of homemade broth made with gelatinous meats/bones, pork rinds, gelatin based deserts made from real gelatin.

Bone broth, made from beef or chicken bones.

Eating avocados helps boost collagen systemically. Eat genistein rich soy and cheese, these foods help boost production of collagen.

Collagen protein powered can be bought in health food stores or online. Buy hydrolyzed powder, it dissolves into liquids easily.

Types of supplements

hydrolyzed collagen provides 90% vs. food, which provides at best 27%.

Beef or bovine collagen provides types 1 and 3.  It helps skin (including gums and blood vessels), nails, hair, tendons, ligaments, muscles and bones (including teeth) and eyes (Axe 2015). Bovine collagen treats osteoarthritis.  It also helps gut health, muscles (building and maintaining/repairing), sleep, skin quality. Source of glycine and proline needed for creatine (Helps in energy production) production, production of muscle tissue and to make body produce its own collagen (Axe, 2015).

Poultry or chicken collagen provides type 2.  Good for cartilage production and general Joint health, it provides glucosamine and chondroitin sulfates, which help maintain bones.  Good source of proline, arginine, glutamine and glycine (Axe, 2015).

Egg based collagen provides types 1, 3, 4 and 10. Egg collagen has glucosamine and chondroitin in it as well as hyaluronic acid and other amino acids (Wong, et al., 1984). It helps with joint an tissue problem, improves skin quality and lessens the appearance of wrinkles, helps improve the range of motion, lessons stiffness and pain and helps with digestion (Axe, 2015).

Fish based collagen (most easily absorbable) provides type 1. Helps vital organs, blood vessels, joint and bone health, digestion and skin.   Source of amino acids proline, hydroxyproline and glycine.  Hydroxyproline is especially important as it helps collagen stay stable and helps in maintaining joint health (Pubhem).

Porcine or pig collagen is similar to bovine collagen. It is cheaper to purchase, but doesn’t absorb as well as other forms, so it doesn’t raise the body’s overall collagen levels as well as bovine or fish (amino-collagen.com).

Type 1: found most often in the body and has types III and V, IVII in it.  Helps form bones, skin, tendons etc…keeps skin strong, elastic and healthy (helps wounds heal). The glycine in it can help with memory, cognitive processes and anxiety.

Type 2: helps build cartilage and connective tissues.  Helps prevent or treat joint problems and arthritis.

Type 3: makes up organ tissue and skin.   Works with type 1 collagen to form tissue and blood vessels.  Deficiency can lead to heart problems (Liu, Wu, Byrne, Krane, & Jaenisch,1997).

Type 4: helps form muscles, organs and fat. It is needed for nerves and blood vessels to work properly (Axe, 2015).   It is necessary for healthy digestive and respiratory systems.

Type 5: helps produce hair and the surface of cells. It is also needed during pregnancy to develop healthy placentas (Axe 2015).

Type 10: helps with bone and cartilage production, maintenance and healing (Shen, 2005).

Type 17a1: helps keep hair follicles healthy.  Found in type 1 collagen (Mandal, 2013).

Taking vitamin C with collagen is recommended as it helps hydroxyproline work at keeping collagen stabile.

Cautions about collagen supplementation: make sure that the source you buy is low in calcium, as too much calcium can lead to health problems. The US Food and Drug Administration labels collagen as a safe supplement. But, those with food allergies or sensitivities should be careful about the source of collagen.  Allergic reactions involving facial/neck swelling, hives, nausea, increased heart rate, stomach upset are rare, but can occur (King, 2017). Also, if you are female and menopausal be aware of the amount of calcium in your chosen supplement, too much calcium may cause health problems.

This information is for education only.  Please consult a qualified health care provider.

See reference page for full list of references regarding collagen pages.

 

 

 

 

 

Iron Deficient Anemia

Iron Deficient Anemia is a condition up to one third of woman may suffer from.  Women who are moving into menopause are more likely to become anemic (3).  Anemia effects cognitive or thought process.  It impacts attention, learning and intellectual ability.  This is probably partly due to iron’s effects on memory (long term, short-term and working memory) as well as emotional well-being (3).  Iron may play a similar role in mood regulation.  There is some data to indicate that low iron levels may underlie the symptoms of depression (3).  Iron is needed for the “feel good neurochemical” dopamine’s receptors to work properly (4).  Dopamine may also be important to the learning process.

Anemia is often caused by one or more of the following: heavy periods or menorrhagia (1), medical conditions like hypothyroidism, or the use of medications like non-steroidal anti-inflammatory drugs (NSAIDs) or antacids (2).

Hypothyroidism can cause anemia in both those with subclinical hypothyroidism and overt hypothyroidism (6). Anemia can also by a symptom of more serious health problems.  Disrupted nutrient absorption due to gastrointestinal problems (irritable bowel syndrome, IBS, coeliac disease or parasitic problems) may account for six percent of women with anaemia (5). Infectious diseases, (hook worm), Renal disease, and auto immune problems may be responsible for anemia (5). Low iron levels are also linked to vaginal infections (7).

Anemia is often diagnosed when a test shows a haemoglobin of 12.0g/dL or below, though other tests may be necessary as hemoglobin can be higher than this, but the person being tested may still be anemic (5). The most common cause of anemia in peri-menopausal women is iron deficiency.  Diets low in iron rich foods (protein, fortified cereal grains and green, leafy, vegetables) may be the culprit (5).  Deficiencies in folate and vitamin B12 can also impact iron deficient anemia.

Diagnosis of anemia usually starts with blood tests focusing on deficiencies in iron, vitamin B12 and folate levels. Other medical tests (liver, thyroid etc.) may also be necessary.

Treatment for anemia

Medical treatments: iron supplements, with B12 and folate may be recommended. Iron supplements should be taken with vitamin C as this helps with absorption.  Avoid taking these with calcium supplements or calcium rich foods as calcium may disrupt iron absorption.  If oral iron does not work, then intravenous iron may by prescribed.  Side effects of oral iron can include diarrhea, constipation and abdominal pain, heartburn, blackened stools and feeling ill (2). Take iron with food if possible.

Once your iron levels return to normal your doctor may recommend you stop taking the supplements after another three months have passed.

Non-medical treatments: revolve around dietary changes. Try to get more protean rich foods. Good sources are: fish, eggs, meat, (red and white); vegetarian sources include brown rice, nus and seeds, pulses (beans and legumes) dried fruit, and iron-fortified bread and cereals and dark green, leafy, vegetables (2).

Try to combine vitamin C rich foods or supplements with iron, as it increases absorption.

Avoid taking iron with the following as it reduces absorption: tea or coffee, antacids or proton pump inhibitors (PPIs), wholegrain cereals that have phytic acid as this stops the absorption of iron from other sources, calcium rich foods or supplements (2).

Taking too much iron can be problematic or even fatal. High quantities of iron can cause liver failure, intestinal and stomach problems and even dangerously low blood pressure and death.  Higher than normal iron levels may also be implicit in heart disease in women with type II diabetes (8).

 

PLEASE NOTE THIS BLOG IS FOR INFORMATIONAL PURPOSES ONLY.  IF YOU HAVE A MEDICAL ISSUE PLEASE CONTACT A QUALIFED HEALTHCARE PROVIDER.

Sources:

1    Cemcor centre for menstrual cycle and ovulation research at UBC website.  Webpage: very heavy menstrual flow.    Retrieved from:  http://www.cemcor.ubc.ca/resources/very-heavy-menstrual-flow

2  British National Health Services website. Web page: Iron deficiency anaemia-treatment.  Retrieved from:  www.nhs.uk/Conditions?Anaemia-iron-deficiency-/Pages/Treatment.aspx

3    Lomagno, K.A., Hu, F., Riddell, L.J., Booth, A.O., Szymlek-Gay, E.A., Nowsen, C.A., & Byrne, L.K. (2014).Increasing iron and zinc in pre-menopausal women and its effects on mood and cognition: A systematic review. Nutrients 6 (11), 5117-5141.doi: 10.3390/nu6115117

4 Youdim, M.B., Ben-Shachar, D., Ashkenazi, R., & Yehuda, S., (1983).  Brain Iron and dopamine receptor function.  Advances in Biochemical Psychopharmacology, (37), 309-321.

5   Kaushik, G. Midlife and Beyond, GM2 (2009). Anaemia in the post-menopausal woman.   GM2 Midlife and  Beyond, June, 37-40.  From gm journal website, webpage:  Anemia in the post-menopausal woman.      Retrieved from:                 www.gmjournal.co.uk/uploadedfiles/redbox/pavilion_content/our_content/scocial_care_and_h                ealth/gm_archive/gm2_2009/june_2009/gm2june2009p.37.pdf

6  Endocrineweb.com website.  Webpage:  study looks at link between anemia and hypothyroidism.  Retrieved from:  www.endocrineweb.com/professional/research-updates/thyroid-disorders/study-looks-link-between-anemia-hypothyroidism

7    Hemalatha, R., Ramalaxmi, B.A., Swetha, G.K., Rao, D.M., Charyulu, S., & Kumar, D. (2012).     Nutritional status, bacterial vaginosis and cervical colonization in women living in an urban slum in  India.     International Journal of Nutrition and Metabolism 4 (5) 77-82. Doi: 10.5897/ijnam12.005.

8  Web MD website. Webpage: find a vitamin or supplement: iron.  Accessed on 5/11/2017.  Accessed at: http://www.webmd.com/vitamins-supplements/ingredientmono-912-iron.aspx?activeingredientid=912

Hot flashes, Sweating & Disturbed Sleep

Also, known as vasomotor symptoms are due to changes in female sex hormones.  When this happens, a woman may experience difficulty sleeping, insomnia or waking in the night, as well as sweating and hot flashes.

Insomnia may increase during perimenopause, due to hormonal fluctuations altering circadian rhythms (10) and sleep patterns.   While insomnia increases in both sexes with age, women are more likely to experience it, starting at the onset of pre-menopause.  Women may in fact experience sleep disruptions five to seven years before the actual onset of pre-menopause (87). Hot flashes (night sweats) are often at the root of insomnia, but other problems like poor health and sleep apnea (especially experienced when overweight) may be the underlying cause.  Anxiety and depression can also play a role in insomnia (80).

Regarding hormonal changes, both oestrogen and progesterone play a part in sleep.   Oestrogen helps regulate magnesium levels. Magnesium is important to sleep as it is associated with muscle relaxation (81).   As women lose the ability to produce oestrogen magnesium production may be compromised.  This in turn impacts the ability to relax and fall asleep.   Low oestrogen may be responsible for night sweats and has been associated with sleep apnoea (breathing problems) during sleep (81).  Progesterone is associated with deep sleep, without it women find it hard to get a restful sleep (81).

Sleep hygiene in imperative to mental and physical wellbeing.  Most adults need seven to nine hours of sleep per night.  A lack of sleep is associated with a lack of concentration, anxiety, (81) depression, and irritability (all associated with menopause).  It is also correlated with being overweight/obese and increased risk of heart disease, high blood pressure, diabetes and substance abuse (88).

How to improve sleep hygiene:  Establishing a sleep routine; change your diet to avoid fatty or sugary foods and caffeine, all of which are associated with being stimulating and underlying night sweats (81); calcium and magnesium may be helpful (81).  Magnesium, often lacking in processed foods.  Magnesium has been shown to increase the ability to get to sleep and stay asleep, and to awaken. Magnesium has been shown to increase melatonin production and decrease stress hormone cortisol production (83) and to reduce the symptoms of treatment resistant depression (82).   Calcium aids in making melatonin from tryptophan (an amino acid).  Melatonin helps regulate sleep/wake cycles and the body’s internal clock (89).  Potassium has been shown to improve the quality of sleep and lesson the likeliness of sleep disruption (90).

Hot flashes and night sweats may be due to rapid changes or fluctuations in ovarian hormones.  Hot flashes usually occur early in perimenopause, and come and go depending on the severity of hormonal fluctuations (10).  Some women continue experiencing hot flashes for years after menopause.

Disruptions in the body’s ability to regulate temperature may in part be due to a disruption in the production of certain neurotransmitters (serotonin and noradrenaline).  These neurochemicals help to stabilize what is called the thermoneutral zone.  Sex hormones play a role in the production of neurotransmitters, so when estrogen etc. starts to fluctuate so does the production of serotonin and noradrenaline.  This in turn can disrupt the body’s ability to regulate heat and cold.  So, if you can increase the production of these neurotransmitters, by natural or artificial means, it may help. There are activities and foods or supplements you can take to increase them naturally.  Some anti-depressants/anti-anxiety medication can also help with this.  These are SSRIs (selective serotonin re uptake inhibitors) and SNRIs (Serotonin nor-epinephrine re-uptake inhibitors).  Keep in mind that this will help, but might not completely reverse the problem (294).

Natural ways to increase the production of serotonin include, but are not limited too, the following:

Light therapy (especially blue spectrum light) increases serotonin.  When possible walk out doors in bright sunlight for 15 minutes a day (134;135).  Otherwise, you can buy an inexpensive light box.  Keep in mind that blue light can harm your eyes, so don’t look directly at it.  Also, avoid blue light at night as it may affect the ability to go to sleep (including TV and tablet screens).   If you purchase a blue light box place it on a high enough surface to allow the light to hit the lower part of the eye, as this is where blue spectrum light naturally is absorbed (178).

Nutritional interventions to increase serotonin include the following: turmeric, dark chocolate, green tea, cold-water fatty fish, and fermented foods (yogurt, kefir, unpasteurized sauerkraut).  The last helps balance gut bacteria as too much of a bacterium called lipopolysaccharides can lower serotonin levels (264;267;268).   Eat tryptophan rich sweet or starchy (ideally complex) carbohydrates without protein (264; 273;274) as protein has nutrients that disrupt the uptake of tryptophan.  Eat   carbohydrates on an empty stomach (about three hours after a protein).  The food source (like gram crackers, pretzels etc.,) should have at least 25 to 35 grams of carbohydrates and no more than 4 grams of protein.  If you want a quick boost to your mood try a simple carbohydrate, but keep in mind that this will raise your blood sugar as well.  You should feel an effect 20 to 40 minutes after eating (274).  See appendix for books on the subject.

Reduce or eliminate caffeine as it may desensitize brain cells to serotonin (266), and avoid artificial sweeteners (aspartame) as it inhibits the uptake and conversion of tryptophan (264;265).

Exercise increases the production of neurotransmitters Dopamine, Norepinephrine and Serotonin (22).

Hot flashes may also be the result of blood vessels losing elasticity.  This is called endothelial dysfunction. Here blood vessels stop functioning properly, by not constricting (narrowing) or dilating (widening) properly to accommodate proper blood circulation (187).  Endothelial dysfunction may be the result of an inability to properly produce the neurotransmitter nitrogen monoxide.

Treatment for vasomotor problems like hot flashes or night sweats include the following.    Taking the amino acid arginine may help as it is made into nitrogen monoxide by the body (188).  If you choose to take arginine take amino acid lysine with it.  Lysine will help keep arginine circulating in the blood to be transformed into nitrogen monoxide (189; 190).

Soy has been shown to improve hot flashes (19; 24; 54), for instance adding approximately 100 mg of soy isoflavone per day, in the form of a supplement, may decrease vasomotor symptoms (19). Those with thyroid problems should avoid soy as it is a phytoestrogen and may lead to estrogen dominance, which negatively effects thyroid functioning.  Vitamin E (800-1200 IU), and Black Cohosh (dose of 40 mg/1 to 2 times a day) may also help (51;54).  Saint John’s Wort, (Hypericum peroratum L or HPL) may relieve hot flashes (26).  Keep in mind that Black Cohosh can cause rash, liver damage, and stomach upset (54).

Exercise should not be overlooked. Women hen exercising women report feeling more in control of their lives and bodies when they exercise.    Women also report more positive feelings towards their overall situation, and say they are less distressed by these symptoms, regardless of their actual intensity (41).

Magnesium supplements have been shown to lessen the number of, and intensity of hot flashes, increase  the ability to sleep and lessen night sweats (194) and reduce the severity of hormone related migraines (201).  It can also help treat arrhythmia or disturbances to heart beat (201). Magnesium is also needed for Vitamin D to be properly absorbed (201).

Recommended oral intake of magnesium for adults (not breast feeding or pregnant) is 310 to 350 mg (194), and specifically 320 mg per day if female and over age 31 (198).  Magnesium supplements come in different forms.  These are the ones that absorb most easily: Magnesium citrate, magnesium lactate, and magnesium gluconate (198).   Epson salts have magnesium in them and some of it is absorbed via the skin.  This may explain why Epson salts relieve muscle pains, inflammation and swelling (198).

Keep in mind that magnesium supplements can interact with medications, so only take them under a health care provider’s supervision.  If you have kidney disease you may not be able to take magnesium supplements.  Too much magnesium can result in the following: lowered pulse rate and low blood pressure, problems breathing, nausea and vomiting and fatigue.  Fee Infrequently it has caused coma and death (197). Hormone replacement therapy (HRT) may lessen the loss of magnesium (196; 198; 201).

Foods high in magnesium are: seaweed, green leafy vegetables (spinach & beat greens), bananas, chocolate & coco powder, legumes (including peanuts), seeds (poppy, fennel, cumin, celery, pumpkin & squash), nuts (Brazil, almonds, cashews, pine, black walnuts), and whole grains (whole wheat flour, wheat bran, oat flour, oatmeal, and bran cereals), and fish, diary, tofu and soybean flour (197;198).

Herbs and spices high in magnesium: marjoram, tarragon, savory, basil, sage, dill weed, coriander, and blackstrap molasses.

Magnesium is also in some medications (199) like laxatives, heart burn medicine (Rolaids Extra-strength) and diarrhea medications (Phillips’ Milk of Magnesia).

Hormone replacement therapy (HRT) is also a good treatment for vasomotor symptoms, but it is also potentially problematic as it may increase the likelihood of developing   other health problems (294).

REFERENCES UPON REQUEST

Menopause related depression


Up to 29% of women will experience depression during the menopausal change.   This is   depressive symptoms can be caused by the erratic highs and lows of ovarian hormonal fluctuations (1;2;3). In the female brain estrogen is a neuromodulator, meaning it can change or disrupt the production of neurotransmitters, including those involving mood.  In most women, until the onset of pre-menopause, the brain is able to deal with changes brought on by fluctuating hormones during the menstrual cycle.  At the onset of pre-menopause some women (with a history of depression, premenstrual depression or postpartum depression/baby blues or genetic vulnerability to depression) may be vulnerable to hormone related depression (1).   The symptoms of depression are tiredness, sadness, irritability, disinterest in things and even anger.  These symptoms are due in part to wild shifts in sex hormones, which then effect neurotransmitter production (1;2;3).  The group of women most likely to experience this experience have experienced depression, or hormone related low mood (baby blues, pre-menstrual syndrome, postpartum depression) before (1).

Between 18% and 29% of women will experience hormonally related menopausal depression (1), and for those who are effected the “inability to rapidly establish a new baseline of neuronal function could lead to increased susceptibility to mood disorders and diminished brain-related functions” (1, p.5). In other words, your ability to think clearly may be altered and your mood may become depressed or erratic.

This is in part because the adrenal glands, which produce sex hormones (4) in the female body (up to 50% after menopause) also produce stress related hormones, like cortisol and adrenaline.  If the adrenals are producing stress hormones, they are less likely to be able to make sex hormones at the same time (5).  Ironically, in this situation stress and depression act like a feedback loop, making it harder for women to regulate ovarian hormones, which can lead to early onset menopause (1).  To make matters worse, if a woman’s body is under prolonged stress, her body will convert progesterone (a sex hormone) into cortisol (a stress hormone).  Cortisol then disrupts the brains production f something called BDNF (Brain-derived neurotrophic factor) which is associated with keeping the brain healthy (helping make new neurons and connections between existing neurons).  Low levels of BDNF have been connected to depression (53).  If a person stops making enough BDNF to keep their brain healthy for a long enough time, parts of the brain will start to atrophy or shrink (6).

How to deal with these problem:

Sleep hygiene is important.  Having a routine helps maintain dopamine levels (56).

Manage stress, high stress levels are connected to low dopamine levels (56).

Exercise is important to psychological well-being as it is thought to increase the production of neurotransmitters (Dopamine, Norepinephrine and Serotonin) that are necessary to feel happy (32).  It also increases blood circulation in the brain which positively impacts hormones and increases dopamine levels (56).  Exercise forces the brain to make BDNF (7). It is also linked to improved mood and feeling fewer physical symptoms of menopause (34;35). In fact, menopausal women who exercise have been shown to assess their symptoms as being less important and so cope better with them (36).  Do yoga, it helps make the neurotransmitter GABA (gamma-aminobutric acid) which lessens anxiety and helps keep you calm.  Yoga can you learn to control negative emotions like anger, anxiety & depression, (37). It may be better than cognitive behavioral therapy for stress management, anxiety and depression (38).    Exercise helps make the hormone DHEA (Dehydroepiandrosterone) (41), which helps depression (39) self esteem and low energy (40).  DHEA can improve immune response (41) and memory (42).  Exercise four times a week to improve GABA.  Get enough sleep, as this helps balance hormones and neurotransmitters (52).

Dietarily:

To increase GABA eat foods high in glutamic acid: oats or whole wheat or whole grains, almonds or tree nuts, oranges and other citrus fruits or bananas, beef liver, halibut, lentils, broccoli, brown rice, rice bran, potato’s (52).

For BDNF production eat oily fish, blue berries, red grapes, eat dark chocolate (12;13).

For DHEA eat good fats and with plenty of omega 3 fatty acids.  Eat pumpkin seeds, raw butter, ghee, and the following oils: flax, palm, olive and cod liver (43).

For serotonin eat the following foods to naturally increase serotonin: turmeric, dark chocolate, green tea, cold-water fatty fish, and fermented foods (yogurt, kefir, unpasteurized sauerkraut).  The last helps balance gut bacteria as too much of a bacterium called lipopolysaccharides can lower serotonin levels (22;26;27).  Also, eat Tryptophan (an amino acid) rich foods.   Eat carbohydrates, these make more serotonin than protein based foods with Tryptophan.  Protein has been found to block the production of serotonin so, eat sweet or starchy (ideally complex) carbohydrates without protein (22;23; 24).  Eat low or fat free and protein free carbohydrates on an empty stomach (about three hours after a protein).  The food source (like gram crackers, pretzels etc.,) should have at least 25 to 35 grams of carbohydrates and no more than 4 grams of protein.  Try to eat less than three grams of fat per serving as this can increase your weight.  If you want a quick boost to your mood try a simple carbohydrate, but keep in mind that this will raise your blood sugar as well.  You should feel an effect 20 to 40 minutes after eating (25).

For dopamine eat bananas, (the riper the better), almonds, apples, watermelons, cherries, yogurt, beans, eggs, and meats (56).

Drink green and black tea to increase BDNF (12;13).

Do not eat sugar, processed foods or high fructose corn syrup, as these disrupt BDNF production (10) and dopamine (56).

For BDNF take these supplements: zinc, magnesium (14) and curcumin supplements, or cook with the spice turmeric (11;51) or curcumin (8).

 

For dopamine address any magnesium deficiencies (56). Symptoms include cravings for salt and carbohydrates, having high blood pressure, being constipated, muscle spasms or pain, head ache or being tired, mood swings (anxiety or irritability) and other signs of depression, and having heart palpitations or a rapid heartbeat (56).

For dopamine take vitamins C and E (56).

Take vitamin B6 to increase GABA (52).

Regarding DHEA, in Canada it is only available as a prescription (44).  Conversely, DHEA is available for sale as a supplement in the US (45).

Some antidepressants do work to increase BDNF production (9).

Reduce or eliminate caffeine as it may desensitize brain cells to serotonin (46) and dopamine levels decrease after drinking coffee (56), and avoid artificial sweeteners (aspartame) as it inhibits the uptake and conversion of tryptophan (22; 47).

For depression in general adding vitamins (B6, B9 and B12), and supplements (SAM-e, that is S-adenosylmethionine) to your diet can help (28; 29). Magnesium has been found to substantially help with treatment resistant depression (82) as have vitamin D and amino acids, especially tryptophan (30).

Take the amino acids tyrosine and l-phenylalanine or phenylalanine (which the body makes into tyrosine) to make dopamine.

Chlorella, a green alga, has been shown in clinical trials to reduce the symptoms of depression and anxiety (31). Kava extract has been effective for some people as an alternative to pharmaceuticals (4).

The following have also been shown to improve mood in depressed individuals:  music therapy, and relaxation training (33).

To increase both serotonin and BDNF eat probiotics and prebiotics.  Eating probiotics (bacterial culture found in fermented foods like yogurt, kimchi, pickles and sauerkraut) or taking supplements and prebiotics help relieve depression, anxiety and thought related problems (54).  Eat lactobacillus rhamnosus (55) Lactobacillus casei Lactobacillus helveticus and Bifidobacterium longum (54). Serotonin and BDNF production is also improved by eating prebiotics (starches that nurture good bacteria) like squash, onions, sweet potatoes and asparagus can also help increase BDNF (14;15) and serotonin.

Treatment for depression: Peri-menopausal depression and premenstrual symptoms also respond to hormone replacement therapy (HT/HRT) (1). And, many women opt for estrogen replacement therapy (ERT) (16; 17) which has been shown to increase a sense of well-being (18). For some postmenopausal women, HRT combined with a type of anti-depressant/anti-anxiety drug, selective serotonin reuptake inhibitors (SSRIs) may work better than SSRIs alone (1).   Others may opt for natural remedies.

In some studies light therapy (especially blue light) has recently been proven more effective than anti-depressants in treating depression (19) and combining light therapy with antidepressants was even more effective. Blue light exposure helps anxiety as well.  It increases production of serotonin and may strengthen and stimulate the areas of the brain responsible for processing emotion and language.  This in effect enables better handling of stressful situations and greater mood regulation (20).  Ideally you would get enough light naturally, by walking outside in sunlight for 15 minutes a day.  Alternatively, you can buy an inexpensive light box at most retailers, or online, or try installing full-spectrum high-quality (fluorescent) lightbulbs in your home and place of work.  Keep in mind that blue light can harm your eyes, so don’t look directly at it.  Also, avoid blue light at night as it may affect the ability to go to sleep (including TV and tablet screens).   If you purchase a blue light box place it on a high enough surface to allow the light to hit the lower part of the eye, as this is where blue spectrum light naturally is absorbed (21).

Other pre-and perimenopause related medical problems that cause depressive symptoms and anxiety are thyroid problems (48), deficiencies in B vitamins (especially B 6 and 12 [49]) and iron (anemia) due to excessive bleeding (50).

References:

1   Deecher, D., Andree, T.H., Sloan, D., & Schechter, L.E., (2008).  From menarche to menopause: Exploring the underlying biology of depression in women experiencing hormonal change.   Psychoneuroendocrinology, 33, 3-17.

2   Epperson, C.N., Amin, Z., Ruparel, K.L., Gur, R., & Loughead, J., (2012).  Interactive effects of      estrogen and serotonin on brain activation during working memory and affective processing in menopausal women.  Psychoneuroendocrinology, 37, 372-382.

3 Pearlstein, T.B.  (1995).  Hormones and depression: What are the facts about premenstrual syndrome, menopause, and hormone replacement therapy? American Journal of Obstetric Gynecology, 173, (92) 646-653.

4   Pittler, M.H., & Ernst, E., (2000).  Efficacy of Kava extract for treating anxiety: systematic review and meta-analysis.  Journal of Clinical Psychopharmacology, 20 (1), 84-89.  Accessed: http://journals.lww.com/psychopharmacology/Abstract/2000/02000/Efficacy_of_Kava_Extract_for_Treating_Anxiety.14.aspx

5   Women to women website, run by Dr. Marcelle Pick, OB-GYN, NP.  Webpage:  Am I in menopause.  Accessed at:  https://www.womentowomen.com/menopause-perimenopause/am-i-in-menopause-2/

6   Warner-Schmidt JL, Duman RS (2006). Hippocampal neurogenesis: opposing effects of stress and antidepressant treatment. Hippocampus. 16 (3): 239–49. doi:10.1002/hipo.20156. PMID 16425236.

7   Russo-Neustadt AA, Beard RC, Huang YM, Cotman CW (2000). Physical activity and antidepressant treatment potentiate the expression of specific brain-derived neurotrophic factor transcripts in the rat hippocampus. Neuroscience, 101 (2): 305–12. doi:10.1016/S0306-4522(00)00349-3. PMID 11074154.

8  Xu Y, Ku B, Tie L, Yao H, Jiang W, Ma X, Li X (Nov 2006). “Curcumin reverses the effects of chronic stress on behavior, the HPA axis, BDNF expression and phosphorylation of CREB”. Brain Research. 1122 (1): 56–64.                      doi:10.1016/j.brainres.2006.09.009. PMID 17022948.

 9   Shimizu E, Hashimoto K, Okamura N, Koike K, Komatsu N, Kumakiri C, Nakazato M, Watanabe H, Shinoda N, Okada S, Iyo M (Jul 2003). Alterations of serum levels of brain-derived neurotrophic factor (BDNF) in depressed patients with or without antidepressants. Biological Psychiatry. 54 (1): 70–5. doi:10.1016/S0006-3223(03)00181-1.

10   Rendeiro, C., Vauzour, D., Rattray, M., Waffo-Teguo, P., Merillon, J.M., Butler, L.T., Williams, C.M., & Spencer, J.P., (2013).  Dietary levels of pure flavonoids improve spatial memory performance and increase hippocampal brain-derived neurotrophic factor.  Plos One 8 (5) Doi: 10.1371/journal.pone.

11 Mishra, S., & Palanivelu, K. (2008).  The effect of curcumin (tumeric) on Alzheimerès disease: An overview.  Annals of Indian                   Acandemy of Neurology, 11, (1), 13-19.

12    The Longevity plan with Dr. John Day website.  Webpage: 081 10 ways to boost brain function with BDNF.  Accessed            on: March 15th, 2017.   Accessed at: http://drjohnday.com/10-ways-to-boost-            brain-function-with-bdnf/

13    Fengj, H., & MacGregor, G.A. (2001). Beneficial effects of potassium.  The BMJ, 323, 497-501.

14   Webpage: Optimal Living Dynamics. Webpage: 21 proven ways to increase your brain’s growth hormone.   Accessed at:                       http://www.optimallivingdynamics.com/blog/21-proven-ways-to-increase-your-brains-growth-hormone

15    Savignac, H.M., Corona, G., Mills, H., Chen, L.  Spencer, J.P.E., Tzortzis, G., & Burnet, P.W.J., (2013).  Prebiotic feeding elevates central brain derived neurotrophic factor.  N-methyl-D-aspartate receptor subunits and D-serine.  Neurochemistry International 63 (8) 756-754.  Doi: 10.1016/j.neuint.2013.10006

16  Han, K.K., Soares, J.H., Haidar, M.A., deLima, G.R., & Baracat, E.C. (2002).  Benefits of soy isoflavone                                         therapeutic regiment on menopausal sysmtoms. Obstetrics & Gynocology, 99, (3)389-394.

17    Fagulha, T., Goncalves, B., & Ferreira, A. (2011).  A population-based assesment of midlife portuguese women’s experience of primenopuase and menopause.  Health Care for Women International, 32, 559-580.

18   Streeter, C.C., Whitfield, H., Owen, L., Rein, T., Karri, S.K., Yakhkind, A., Perlmutter, R., Prescot, A., Renshaw, P.F., Ciraulo, D.A., & Jensen, J.E. (2010).  Effects of yoga versus walking on mood, anxiety, and brain GABA levels:  A randomized contgrolled MRS study.  Journal of Altrnative and Complentary Medicine, 16, (11), 1145-1152.

19    Lam, R.W., Levitt, A.J., Levitan, R.D., Michalak, E.E., Cheung, A.H., Morehouse, R., Ramasubbu, R., Yatham, L.N., & Tam        , E.M., (2016).  Efficacy of bright light treatment, Fluoxetine, and the combination in patients with non-seasonal    major depressive disorder, JAMA Psychiatry, 73 (1), 56-63.

20   Mercola website.  Webpage: Blue light may be key to fighting winter blues.  Accessed:                 www.articles.mercola.com/sites/articles/archive/2010/14/blue-light-may-be-key-to-fighting-winter-            blues.aspx

21    Psych Education website.  Webpage:  Light Therapy for Depression.  www.psycheducation.org/treatment/bipolar-               dosorder-light-and-darkness/light-thrapies-for-depression.

22     Be Brain Fit website.  Webpage: Serotonin foods and mood disorders, by Alban, D. accessed at: http:    bebrainfit.com/serotonin-foods-mood-brain/

23     Sayegh, R., Schiff, I., Wurtman, J., Spiers, P., McDermott, J., & Wurtman, R., (1995).  The effect of a       carbohydrate-rich beverage on mood, appetite, and cognitive function in women with       premenstrual syndrome.  American Journal of Obstetrics & Gynecology, 86 (4, pt. 1) 520-528.

24   Draw it out website.  Webpage:  drawing of lifestyle retrieved from: http://drawitout.co.uk/portfolio/a- healthy-diet-for-a-  healthy-life/

25     RX list, the internet drug index website.  Webpage: Boniva.  Accessed at: http://www.rxlist.com/boniva-              drug/patient-images-side-effects.htm

26   Bercik, P., Denou, E., Collins, J., Jackson, W., Lu, J., Deng, Y., Blennerhassett, P., Macri, J., McCoy, K.D.,            Verdu, E.F., & Collins, S.M., (2011).  The intestinal microbiota affect central levels of brain-derived            neurotropic factor and behavior in mice.  Gastroenterology 14 (12) 599-609.  Doi:         10.1053/j.gastro.2011.04.052.

27    O’Connor, J.C., Lawson, M.A., Andre, C., Moreau, M., Lesage, J., Castanon, N., Kelley, K.W., & Dantzer, R.,       (2009). Lipopolysaccharide-induced depressive-like behavior is mediated by indoleamine 2,3-dioxygenase activation in mice.   Molecular Psychiatry 14, 511-522.

28   Volker, D., & Jade, N.G. (2006).  Depression: Does nutrition have an adjunctive treatment role?  Nutrition & Dietetics, 63, 213-226.

29   WebMD website. Webpage: Vitamins and Supplements Lifestyle Guide, SAM-e (S-adonosylmethionine, SAMe).  Retrieved from,www.webmd.com/vitamins-and- supplements/lfiestyle-guide-11/suppliment-guide-sam-e

30     Nerogestics, the brain wellness program website.  Webpage:  Amino acids. Accessed:                 https://www.neurogistics.com/TheScience/AminoAcids.asp

31    Panahi, Y., Badeli, R., Karami, G., Bandeli, Z., & Sahebkar, A., (2015).  A randomized controlled trial of 6-week Chlorella vulgaris                 supplementation in patients with major depressive disorder.  Complementary Therapies in Medicine, 23 (4), 598-602.

32   Kita, I. (2014).  Physical exercise can induce brain plasticity and regulate mental function.  Advances in Exercise      and Sports Physiology, 20, (1), 1-7.

33    National Institutes of Health, National Center for Compementary and Integrative Health web site.  Web page:  NCCIH Clinical Digest for health professionals. What science says, Octover 2015.  Retrieved from                                            http://nccih.nih.gov/health/providers/digest/depression-science#heading1

34  Fagulha, T., Goncalves, B., & Ferreira, A. (2011).  A population-based assesment of midlife portuguese women’s     experience of primenopuase and menopause.  Health Care for Women International, 32, 559-580.

35   Santin, A.P., & Ferlanetto, T.W. (2011).  Role of estrogen in thyroid function and growth regulation.                                         Jornal of Thyroid Research, 2011, article ID 875125, 7 pages.  Doi: 10.461/2011/87525

36   Sakson-Obada, O.l, Wycisk, J. (2015).  The body self and frequency, intensity and acceptance of menopausal symptoms.  Menopause Review, 14, (2), 82-89

37    Shapiro, D., Cook, I.A., Davydov, D.M., Ottaviani, C., Leuchter, A.F., & Abrams, M. (2007).  Yoga as a complementary treatment of depression: Effect of traits and moods on treatment outcome.  Evidence Based Complement Alternative Medicine,  4, (4), 493-502.

38      Morgan, A. (1999).   Sahaja Yoga:  an ancient path to modern mental health? (Unpublished doctoral thesis).        University of Plymouth, Plymouth United Kingdom.  Retrieved from          http://ethos.bl.uk/OrderDetails.do?uir=uk.bl.ethos.580483

39      Wolkowitz, O.M., Reus, V.I., Roberts, E., Manfredi, F., Chan, T., Raum, W.J., Ormistron, S.,      Johnson, R., Canick, J., Brizendine, L., & Weingartner, H. x

Owen M. Wolkowitz

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Affiliations

  • Department of Psychiatry, University of California, San Francisco, USA
  • Center for Neurobiology and Psychiatry, University of California, San Francisco, USA

Correspondence

  • Address reprint requests to Owen M. Wolkowitz, M.D., Department of Psychiatry, University of California, San Francisco, School of Medicine, 401 Parnassus Avenue, Box F-0984, San Francisco, CA 94143-0984.

(1997).    Dehydroepiandrosterone (DHEA) treatment of depression.  Biological Psychiatry 41 (3): 311-318

40    Watson, S., & Mackin, P., (2006).  HPA axis function in mood disorders. Psychiatry 5 (5): 166-170.  Doi: 10.1383/psyt.2006.5.5.166

41    Heaney, J.L.J., Carroll, D., & Phillips, A.C., (2013).  DHEA, DHEA-S and cortisol responses to acute exercise in older adults in relation to exercise training status and sex.   Age (Dordr) 35 (2):395-405.  Doi: 10.1007/s11357-011-9345-y

42    Wolkowitz, O.M., Reus, V.I., Roberts, E., Manfredi, F., Chan, T., Raum, W.J., Ormistron, S., Johnson,        R., Canick, J., Brizendine, L., & Weingartner, H., (1997).  Dehydroepiandrosterone (DHEA) treatment for depression.  Biological Psychiatry 41 (3): 311-318.

43    Body ecology, the way to be website.  Webpage: if you really want to avoid early aging, get to know “DHEA”. Accessed on March 17, 2017.   Accessed at: http://bodyecology.com/articles/avoid_early_aging_dhea.php

44    Health Canada website.  http://webprod.hc-sc.gc.ca/nhpid-        bdipsn/ingredReq.do?id=4639&lang=eng

45   Kornblut, A.E., & Wilson, D., (2005).  How one pill escaped the list of controlled steroids.  The New          York Times, April 17, 2005.  Accessed at: http://www.nytimes.com/2005/04/17/us.how-one-pill-escaped-the-list-of-contoled-steroids.html?_r=o

46   Web MD website.  Webpage: Foods that fight winter depression.  Accessed on March 3rd, 2017.    Accessed at:                 www.webmd.com/depression/fetatrues/foods-that-fight-winter-depression#1

47     Sharma, R.P., & Coulombe, R.A., (1987).  Effects of repeated doses of aspartame on serotonin and its metabolite in various regions of the mouse brain.  Food Chemical Toxicology, 24 (8): 565-568.

48   WebMD website.  Webpage: Thyroid symptoms and solutions. Retrieved from,         www.webmd.com/depresson/guide/depression-the-thyroid-and-hormones

49   Health span website, webpage: Soothing menopausal stress with vitamin B.  Accessed:             www.healthspan.co.uk/menopause-advice/depression/soothing-menopuasal-stress-with-vitamin-b

50  New York Times website.  Webpage: The New York Times Health Guide, Anemia.  Retrieved from:                 www.nytimes.com/health/guides/disease/anemia/symptoms.html

51   Aggrawal, B.B., & Harikumar, K.B., (2009).  Potential therapeutic effects of Curcumin, the anti- inflammatory agent, against neurogenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases.  The International Journal of Biochemistry & Cell Biology,      41 (1): 40-59.

52     Braverman, E., M.D., (2015).  The Edge Effect: Achieve Total Health and Longevity with the      Balanced Brain advantage.   Sterling.  New York.

53  Bun-Hee L., & Yong-Ku, K., (2010). The roles of BDNF in the pathophysoiology of major depression and in                antidepressant treatment.   Psychiatgric Investigation,  7 (4):231-235.

54   Bested, A.C., Logan, A.C., & Selhub, E.M., (2013). Intestinal microbiota, probiotics and mental health:      form Metchnikoff to modern advances: part 111-convergence toward clinical trains.   Gut               Pathogens 5 (4) Doi: 10.1186/1757-4749-5-4

55   Borrelli, L, Aceto, S., Agnisola, C., De Paolo, S., Dipineto, L., Stilling, R.M., Dinan, T.G., Cryaon, J.F.,     Menna,   L.F., & Fioretti, A., (2016).  Probiotic modulation of the microbiota-gut-brain axis and behaviour in zebrafish.             Scientific Reports 6 30046.  Doi: 10.1038/srep30046

56      University Health News. Am I Depressed? Treating Depression Symptoms, Including Bipolar,     Clinical, and Seasonal Affective Disorder.  Belvoir Media Group.  Norwalk, Conn. Accessed                 at: universityhealthnews.com.

potassium deficiency..menopause

Vitamin and mineral deficiencies may be attributed in part to night sweats.

Potassium deficiency (hypokalemia) may be a partial result of menopause. Here night sweats lead to fluid loss. This reduces the body’s ability to maintain a proper balance of nutrients like potassium (158).  Potassium is an electrolyte (these conducts electricity in the cells of the human body).  Potassium helps regulate nerve impulses, digestion, blood pressure, and helps muscles contract and the heart beat properly.

Low potassium can cause bloating, stomach pain and fluid retention (159) all symptoms of PMS. Low potassium has also been associated with glucose (blood sugar) intolerance and impairment of the body’s ability to produce or secrete insulin (174). Low blood sugar can lead to brain fog or confusion (including problems with decision making), sweating, heart palpitations and feeling jittery, teary and irrationally   angry (184).  These are also symptomatic of menopause.

Low potassium levels have also been shown to be a precursor too, and potential cause of, the development of Type II diabetes (177). Low potassium may lead to more calcium being excreted from the body which can result in an increased risk of bone demineralization and kidney stones (174) in the short term and osteoporosis in the long term (183).

Other symptoms of low potassium levels are muscle problems (muscle fatigue, twitches, cramps, and weakness), and feeling tired (186).

The normal range for potassium in the blood is 3.5 to 5.0 mEq/Litre of blood. As the kidneys excrete this same amount from the body daily a person must maintain a healthy potassium level by eating between 70 and 100 mEq of potassium or 270 to 390 milligrams per decilitre (176).  The average adult in America gets approximately 2.700 milligrams (2.7 grams) of potassium a day.  Adults should get about 90 mEq a day. That means eating foods with the combined equivalent of 3,500 to 4,700 milligrams or 3.5 to 4.7 grams per day (182, 183).

Keep in mind that excessive intake of potassium (hyperkalemia) is fatal, causing cardiac arrest or heart attack (182). Hyperkalemia is considered to be consuming 18 grams or more per day of potassium for an adult.

Good sources of potassium are (176):

Meat like beef, turkey and fish.

Vegetables like mushrooms, tomatoes, peas, beets and greens.

Fruit (dried, fresh or juiced) apricots, prunes, avocados, strawberries, cantaloupe, bananas, kiwi, and oranges or grapefruit

PLEASE NOTE THIS BLOG IS FOR INFORMATIONAL PURPOSES ONLY.  IF YOU HAVE A MEDICAL ISSUE PLEASE CONTACT A QUALIFED HEALTHCARE PROVIDER.

Sources:

158  Website:  34 menopause symptoms, webpage: night sweats and vitamin deficiency.  Accessed at: www.34-menopauses-symptoms.com/night-sweats-and-vitamin-deficiency.htm

159   Symptoms and treatment website. Webpage: symptoms of low potassium in women.  Accessed:  http://symptomstreatment.org/symptoms-of-low-potassium-in-women/

174 Rowe, J.W., Tobin, J.D., Rosa, R.M., & Andres, R.  (1980). Effect of experimental potassium                deficiency on glucose and insulin metabolism.   Metabolism, 29 (6), 498-502.

175   Fengj, H., & MacGregor, G.A., (2001). Beneficial effects of potassium. The BMJ, 323, 497-501.

176   Medicine net website.  Webpage:  low Potassium (Hypokalemia).  Author:  Wedro, B., MD.                                               Accessed:  http://www.medicinenet.com/low_potassium_hypokalemia/article.htm

177   Ekmekcioglu, C., Elmadfa, I., Meyer, A.L., & Moeslinger, T., (2016).  The role of dietary potassium in                 hypertension and diabetes. Journal of Physiology and Biochemistry, 72, (1), 93-106.

182   Recommended Dietary Allowances, 10th Edition. (1989). National Research Council.              National Academy Press, Washington D.C.

183   He. F.J., & MacGregor, G.A., (2008). Beneficial effects of potassium on human health. Physiologia Plantarum, 133 (4), 725-735.

184   Johns Hopkins medicine website. Webpage: Article 87840, Get off the blood glucose roller coaster. Must know health info, Johns Hopkins medicine.  Accessed:  www. Hopkinsmedicine.org/diabetes/diabetes_educaiton/patient_educaitomaterial/get_off_the_blood_glucose_rollercoaster.pdf

185   U.S. Department of Agriculture & U.S. Department of Health & Human Services.  Diatary Guidelines for                 Americans, 2010, 7th Edition.  Washington D.C., U.S. Government Printing Office.  December, 2010.                 Accessed: WWW. Dietaryguidelines.gov.

186   Symptoms and Treatment website.  Webpage:  Symptoms of low potassium in women, by administration.                                Accessed:  www.symptomsandtreatment.org/symptoms-of-low-potassium-in-women/

Menopause and Panic Attacks

Panic attacks may increase as the production of estrogen and progesterone goes down. Estrogen helps inhibit the production of the stress hormone cortisol.  As estrogen decreases cortisol production may increase, leading to a rise in both blood sugar and blood pressure.   These changes may lead to feelings of anxiety.  Estrogen is also a neuromodulator that positively impacts serotonin, a neurotransmitter associated with feelings of wellbeing.  As estrogen decreases serotonin may as well, leading to feelings of panic or anxiety.  Progesterone   is important in the production of GABA (gamma-aminobutyric acid), a neurotransmitter responsible for feelings of calm and relaxation.

SYMPTOMS OF A PANIC ATTACK (lasting up to 40 minutes) INCLUDE:

Distressed breathing or hyperventilation Gastrointestinal or abdominal Distress Rapid heartbeat or chest pain Tremors

 

Dry mouth or chocking Tingling fingers/toes

 

sweating Feelings of dread, fear, nervousness, anxiety or apprehension
Feeling like you are dying or going crazy

 

Potential stressors: rapid emotional cycling due to swift shifts in hormones, negative or pessimistic thinking, drinking alcoholic or caffeinated beverages, and vasomotor symptoms like sweating.  Not to be overlooked are life style changes (spouse leaves/dies, parents get older, children leave home), lack of sleep, or shallow breathing.

Possible treatments : psychotherapy, healthy diet, natural remedies and sleep as well as medication. Remember that addressing hormone fluctuations is important. When possible stimulate the production of sex hormones naturally.

Non-pharmacological treatments: mindfulness techniques, meditation, massage, exercise, yoga, good sleep hygiene, deep breathing exercises, stay hydrated (dry mouth may be mistaken for a symptom of panic and accidently trigger an attack).

Herbal treatments include Linden flower, St. John’s wort, Ginseng and Macafem.

Medications: short term use of sedative like medications (Klonopin, Atovan and Xanax)  may bring more immediate relief of symptoms (8). Doctors often prescribe a class of antidepressant called SSRI’s or selective serotonin reuptake inhibitor (Prozac, Zoloft, Celexa, Paxil or Lexapro).  Be aware that some people react to these drugs with intensified symptoms of anxiety and panic. Keep in mind that the SSRI’s and sedatives may increase the users’ likelihood of developing dementia.

To balance sex hormones naturally: consume vitamins B, D and E, as well as cysteine, curcumin, resveratrol, and fish oil, gamma linoleic acid (GLA) selenium and green tea.  Herbs to take: passiflora and valerian root are used by some.  Dietary you may try incorporating soy which has a substance called genistein in it.  This mimics estrogen. You may want to eat the following foods containing phytoestrogens:

Legumes like soy, alfalfa, black, pinto and lima beans and chick peas or garbanzo beans

Nuts and seeds: pistachio, chestnuts and walnuts, flax, sesame, and sunflower

Vegetables: cauliflower and broccoli, garlic, collards, green beans, olives & olive oil, winter squash.

Fruits: dried apricots, peaches, oranges, dried dates, cranberries and dried prunes.

Herbs: licorice, ginseng, oregano, macafem and sage

Whole grains and flaxseed

Red wine has some phytoestrogens as does V8 and green tea.

PLEASE NOTE THIS BLOG IS FOR INFORMATIONAL PURPOSES ONLY.  IF YOU HAVE A MEDICAL ISSUE PLEASE CONTACT A QUALIFED HEALTHCARE PROVIDER.

References & Sources:

1   Women to women website, run by Dr. Marcelle Pick, OB-GYN, NP.  Webpage:  Am I in menopause. Accessed at:  https://www.womentowomen.com/menopause-perimenopause/am-i-in-menopause-2/

2 A vogel website.  Webpage:  menopause health hub, panic attacks and menopause. Accessed at:                 www.avogel.co.uk/health/menopause/symptoms/panic-attacks/

3   Website: 34 menopause symptoms.  Webpage: panic disorder.  Accessed:                                    http://www.34-menopause-symptoms.com/panic-disorder.htm

4   Dr. Hyman’s website. Webpage: How do I naturally balance female sex hormones?   Accessed:                 http://drhyman.com/blog/2015/08/14/how-do-i-naturally-balance-female-sex-hormones/

5   Academic review: testing popular claims against peer reviewed science. 6.1 –many foods contain                 phytoestrogens. Accessed:  http://academicsreview.org/reviewed-content/genetic-roulette/section-6/6-3-endocrine-                disruptors/

6   Breast cancer fund website.  Webpage:  Phytoestrogens, plant estrogens.  Accessed:                 http://www.breastcancerfund.org/clear-science/radiation-chemicals-and-breast-cancer/phytoestrogens.html

7 website: mental health daily. Webpage: 20 foods high in estrogen (phytoestrogen).  Accessed:                   http://mentalhealthdaily.com/2015/04/08/20-foods-high-in-estrogen-phytoestrogens/

8 Web Md website.  Webpage: Anxiety and   panic disorders health centres.  Accessed:                 http://www.webmd.com/anxiety-panic/understanding-panic-attack-treatment

9 Aging brain care website. Anticholinergic cognitive burden scale.   Accessed:                 www.agingbraincare.org/uploads/products/ACB_scale_legal_size.pdf

Heavy flow equals vitamin B deficiency.

B Vitamins (B 12 and other B vitamins) are necessary for both physical (including cognitive) and emotional  health.  When women experience heavier than normal periods they may find that  a B vitamin deficiency results. The vitamin B group  includes folic acid, B12, thiamine, and niacin.

B vitamins, especially B 1, 3, and 12 are needed to make myelin which coats nerve cells and makes them, and the nervous system, work properly.  Serotonin (a neurotransmitter implicit in emotional wellness and sound sleep) is produced in part from vitamins B 6 and 12. And, B vitamins help relieve stress.
Bone health, which becomes more of a concern as women enter into menopause, is impacted by a lack of B vitamins.  This is as B vitamins are necessary in helping the adrenal glands produce sex hormones, which keep bones strong and dense. Vitamin B 5, pantothenic acid, is especially important for bone health.
Even the liver needs B vitamins to help it break down and eliminate excess sex hormones, if these are deficient the liver may not work optimally and a hormone imbalance may result. Too much of the sex hormone estrogen can impact thyroid functioning negatively, leading to hypothyroidism.

Vitamin B deficiency is indicative by: poor concentration, anxiety and irritability, feelings of tension and an inability to manage stress well .

Symptoms of vitamin B 12 deficiency specifically are: vertigo, dizziness, hair loss, tingling in the extremities, poor appetite, heart palpitations, mouth sores and memory problems. Other causes of vitamin B12 deficiency are: vegan diet or vegetarianism, gastric surgery, and over use of ant-acids.

Vitamin B 6 is necessary to efficiently metabolize carbohydrates, proteins and fats and to support a healthy metabolism.  Symptoms of vitamin B 6 deficiency specifically are: weight gain, irritability, depression, brain fog, and memory problems.
Sources of B vitamins:
B1: liver, eggs, fresh and dried fruit, vegetables (peas)
B2: rice, eggs, fortified cereals and dairy products (milk)
B3: milk/diary, eggs, meat, fish, whole grains
B5: whole grains, broccoli, potatoes, oats, eggs, chicken, beef (kidneys)
B6: avocados, bananas, potatoes, pulses and soya, whole grains, chicken, turkey, eggs, fish, pork
B12: eggs, dairy products, meat and fish/shellfish (vegetarians can get B12 from sea vegetables and fortified foods)
Folic acid: green vegetables, avocados, asparagus, peas, chickpeas, brown rice, oatmeal, liver
If you wish to take a B complex supplement try to find one with 10 mg or more of B1 to B6, over 10 mcg of B12 and 200 mcg or more of folic acid.

PLEASE NOTE THIS BLOG IS FOR INFORMATIONAL PURPOSES ONLY.  IF YOU HAVE A MEDICAL ISSUE PLEASE CONTACT A QUALIFED HEALTHCARE PROVIDER.

sources:

References: 1 Health span website, webpage: Vitamin B12, iron and getting on top of menopausal hair loss. Accessed: www.healthspan.co.uk/menopause-advice/appearance/vitamin-b12-iron-and- getting-on-top-of-menopausal-hair-loss

2 Health span website, webpage: Soothing menopausal stress with vitamin B. Accessed: www.healthspan.co.uk/menopause-advice/depression/soothing-menopuasal-stress-with- vitamin-b

3 Health line website, webpage: B-well: why women in perimenopause need B-vitamins. Accessed: www.healthline.com/health-blogs/hold-that-pause/b-well-why-women-perimenopause-need-b- vitamins

Menopause and Anemia

Iron Deficient Anemia

Up to one third of women may be anemic.  Anemia is often the effect of heavy periods (menorrhagia), other health problems like hypothyroidism, or from medications like antacids or non-steroidal anti-inflammatory drugs. Anemia is diagnosed when a blood test shows a haemoglobin of 12.0g/dL or below . The most common cause of anemia in perimenopausel women is iron deficiency.  Diets low in iron may be the culprit.  Iron rich foods include red meat, fortified cereals, and green leafy vegetables.  Deficiencies in folate and vitamin B12 can also impact iron deficient anemia. Hypothyroidism can cause anemia regardless of type, subclinical hypothyroidism or overt hypothyroidism.  Anemia can also by a symptom of more serious health problems.  Gastrointestinal problems (irritable bowel syndrome, IBS, coeliac disease or parasitic problems) may account for six percent of women with anemia. Infectious diseases, like hook worm, may also be responsible for anemia as can renal disease, auto immune problems and infectious diseases.

Diagnosis of anemia usually starts with blood tests that measure levels of iron, B12 and Folate (folic acid or vitamin M, B9 or Bc).  Liver, thyroid and other tests may also be necessary.

Treatment for anemia

Medical treatments: iron supplements, with B12 and folate  may be recommended. Iron supplements should be taken with vitamin C as this helps with absorption.  Avoid taking calcium supplements or with calcium rich foods as calcium may disrupt iron absorption.  If oral iron does not work then intravenous iron may by prescribed.  Side effects of oral iron can include diarrhea, constipation and abdominal pain, heartburn, blackened stools and feeling ill. Take iron with food if possible.

Once your iron levels return to normal your doctor may recommend you stop taking the supplements after another three months have passed.

Non-medical treatments: revolve around dietary changes. Try to get more protean rich foods. Good sources are: fish, eggs, meat, (red and white). Vegetarian sources include brown rice, nuts and seeds, pulses (beans and legumes) dried fruit, iron-fortified bread and cereals and dark green, leafy, vegetables.

Try to combine vitamin C rich foods or supplements with iron, as it increases absorption.

Avoid taking iron with the following as it reduces absorption: tea or coffee, antacids or proton pump inhibitors (PPIs), wholegrain cereals that have phytic acid as this stops the absorption of iron from other sources, calcium rich foods or supplements.

PLEASE NOTE THIS BLOG IS FOR INFORMATIONAL PURPOSES ONLY.  IF YOU HAVE A MEDICAL ISSUE PLEASE CONTACT A QUALIFED HEALTHCARE PROVIDER.

Sources:

British National Health Services website. Web page: Iron deficiency anaemia-treatment. Retrieved from: www.nhs.uk/Conditions?Anaemia-iron-deficiency-/Pages/Treatment.aspx

Cemcor centre for menstrual cycle and ovulation research at UBC website.  Webpage: very heavy menstrual flow.    Retrieved from:  http://www.cemcor.ubc.ca/resources/very-heavy-menstrual-flow

Endocrineweb.com website. Webpage: study looks at link between anemia and hypothyroidism. Retrieved from: www.endocrineweb.com/professional/research-updates/thyroid-disorders/study-looks-link-between-anemia-hypothyroidism

Kaushik, G. Midlife and Beyond, GM2 (2009). Anemia in the post-menopausal woman. GM2 Midlife and Beyond, June, 37-40.  From gm journal website, webpage:  Anemia in the post-menopausal woman. Retrieved from:  www.gmjournal.co.uk/uploadedfiles/redbox/pavilion_content/our_content/scocial_care_and_health/gm_archive/gm2_2009/june_2009/gm2june2009p.37.pdf

 

Hypothyroidism and Menopause

A large number of women with menopausal-like symptoms may be suffering from (undiagnosed) thyroid problems. Approximately 30% to 40% of women develop thyroid problems at some point, and the likelihood of developing it increases with age.   Hormonal changes brought on by entering into perimenopause may be partially responsible for this. During pre or peri-menopause the ovaries decrease production of progesterone leading to “estrogen dominance” or too much estrogen. This proliferation of estrogen engenders an over production of thyroid-binding globulin (TBG) by the liver.  This substance in turn attaches the thyroid hormones (T3/T4) preventing absorption by the cells. This situation may trigger Hashimoto’s disease.

The same symptoms associated with menopause are also indicative of hypothyroidism. These are: weight gain, mood swings, sleep disruptions, depression and fatigue (both). The thyroid gland (part of the endocrine system) regulates the body’s metabolism and influences the reproductive system, appetite, muscle strength, brain, heart, and kidneys.Hypothyroidism may be accompanied by a coldness in the body’s center which is persistent. This differs from the hot/cold experience of menopause including cold extremities (hands/feet), especially “frozen fingers.” This experience is caused by a higher than normal amount of stress hormones called catecholamines produced by the adrenal gland. These make the blood vessels in hands constrict and feel cold.

If you believe you are suffering from hypothyroidism as well as menopause symptoms talk with your health care provider about having your TSH (thyroid secretion hormone) checked. This can be done with a simple blood test. Thyroid replacement therapy may be in order.

How to diagnose thyroid problems: A simple blood test, called a TSH (Thyroid Secretion Hormone) test will indicate whether or not there is a problem. If the TSH test shows your levels to be either in the top quarter of normal or higher than normal your doctor can order a T4 test to find out if your actual thyroid is not performing properly. If a thyroid problem is occurring then the T4 should be in the low normal/lower than normal range. If the TSH is going up and the T4 is going down, but they are still in the normal range ask to be retested in six months. If a woman has borderline thyroid functioning or low iodine intake (another potential cause of thyroid problems) soy foods may increase the risk of hypothyroidism as the phytoestrogen in soy may disrupt the body’s ability to absorb thyroid hormones, including synthetic thyroid hormones provided by medication .

The usual prescription medication for hypothyroidism is Thyroxine (levothyroxine).   If a woman is taking this medication and then starts taking HRT (hormone replacement therapy) she should have her thyroid tested after starting this, as she may need to increase her thyroid meds.  Please be aware that hypothyroidism in menopausal women has been associated with a heightened risk of bone fractures. This is as thyroid hormones are key in maintaining healthy bones.   If a woman is taking thyroid medication she should not take any calcium supplements within four hours of taking the mediation as it may decrease the absorption of it by up to a third.

If you do not need to don’t take thyroid hormones as these can cause heart problems and decrease bone density.

You can undertake lifestyle changes to lessen the production of excess estrogen, or lower the likelihood of coming into contact with estrogen like substances including Phytoestrogens from plant sources and Xenoestrogens from synthetic products . Try not to cook with plastics as these have estrogen mimicking compounds that may leach into your food. Other sources of estrogen mimickers are: lawn and plant fertilizers, cosmetics and nail care products, paint, glue, and cleaning products.  Manage your weight as Xenoestrogens  may be stored in fat cells, leading to thyroid disruption when they are metabolized.

Fat cells  themselves can also make estrogen, so the more fat cells you have  the more problematic this phenomenon becomes. Grains especially can be problematic as they may contain estrogen compounds meant to increase the grain’s growth rate. Cattle and milk farmers use estrogen to increase livestock weight and milk production respectively.  Chicken farming may also involve estrogens. Avoid drinking or using drugs excessively as these disrupt liver functioning. The liver breaks down estrogen and removes it.

Reduce stress, as this lessons the amount of progesterone in the body by  turning the hormone   progesterone into the stress hormone cortisol.   Avoid birth control pills and hormone replacement therapy if possible as they can contribute to estrogen dominance. Try to avoid foods with pesticides as well as those high in sugar, including simple carbohydrates.

PLEASE NOTE THIS BLOG IS FOR INFORMATIONAL PURPOSES ONLY.  IF YOU HAVE A MEDICAL ISSUE PLEASE CONTACT A QUALIFED HEALTHCARE PROVIDER.

Sources referenced

British Thyroid Foundation website, webpage: Thyroid and Menopause. Retrieved from: www.btf-thyroid.org/information/articles/107-thyroid-and-menopause

Cemcor website, the center for menstrual cycle and ovulation research. Perimenopause and Thyroid Problems, common and confusing, retrieved from www.cemcor.ubc.ca/ask/perimenopause-and-thyroid-problems-common-and-confusing#sthash.3KueNbeQ.dpuf

Website Medicinenet.com. Webpage: Doctor’s view archive, thyroid disease & menopause, medical author: R. Mathur, M.D.; medical editor: W.C. Shiel, Jr, MD., FACP., FACR.  Retrieved from: http://medicinenet.com/script/main/art.asp?articlekey=16424&page=2

Website: theperimenopauseblog.com.  Webpage: 35 symptoms of Perimenopause-Hypothyroidism. Retrieved from: www.theperimenopauseblog.com/35-symptoms-of-perimenopause-hypothyroidism/

thyroidpharmacist.com website, webpage: Estrogen Dominance as a Hashimoto’s Trigger. Retrieved from: www.thyropharmacist.com/articles/estrogen-dominance-as-a-hashimotos-trigger

Outsmart disease website, webpage: How estrogen dominance can ruin your thyroid health, posted January 8, 2013. Retrieved from: www.outspartdisease.com/how-estrogen-dominance-can-ruin-your-thyroid-hyealth/

 

Menopause and Dry Skin

Menopause and dry skin
Dry skin, menopause brings about bodily changes that can result in an acceleration of the aging process, specifically a slowdown in hormone synthesis. As well as sex hormones, the body slows the production of growth hormone, melatonin, thyroid hormones and dehydroepiandrosterone (DHEA). The body also slows its production of skin renewing properties collagen and elastin, needed to maintain firmness. Muscles and bones start to thin, changing the appearance of the face and body and the results of sun exposure, poor diet, lack of hydration and smoking may become more apparent. If you are experiencing hypothyroidism your skin may become dry and course.
There are many interventions for age related appearance problems. Skin care is a must, this protects against dehydration and sun as well as microorganisms etc. that can harm the skin. Some creams can help improve production of collagen and elastic fibers. Retinoid (vitamin A) creams promote collagen production. Anti-oxidant rich creams (Vitamin’s C & E together with ferulic acid (found in coffee, apple, artichoke, and orange seed sare the best) copper, selenium and carotenoids. Soy isoflavones are good too. Laser and light therapy can help improve the appearance of skin, as can injectables (Botox).

You may wish to take supplements to fight the signs of aging. Essential fatty acids plump and moisturize skin. Vitamin E stops cell damage. Curcumin (active ingredient of Tumeric) is used to improve skin radiance (glow). It is also a good treatment for eczema, acne and psoriasis. Curcumin is a natural anti-inflammatory (cause of aging) and a natural anti-oxidant, it can be taken in supplement form, eaten as an ingredient in food, turmeric, or used topically in beauty products . DHEA substitution can increase muscle mass, improve the appearance of loose connective tissue (adipose fat or tissue) and help recover one’s physical condition and appearance.  Keep in mind that research is ongoing on DHEA and more studies are needed.

There is week evidence that the supplement Biotin (Vitamin H or B 7) can improve dry, flaky skin.   Biotin can be found in brewer’s yeast, sardines, nuts butters and nuts (almonds, peanuts, pecans and walnuts) cooked eggs, (yolks primarily), whole grains, bananas, mushrooms, soybeans and other legumes (beans).  The less processed the food is, the more Biotin it will contain. It is also found in supplements .  Keep in mind that Biotin (high doses) can cause acne and skin rashes  as well as oily hair. Drink plenty of water to help absorption; start with the minimum dose and gradually increase it; take with proper food in morning or evening; take with other multivitamins to avoid imbalances.  If you smoke, are on kidney dialysis, or are taking anti-seizure medication or a long term course of antibiotic’s, talk with your health care provider before taking it.  In very rare cases Biotin, when mixed with B 5, may cause a medical condition  called Eosinophilic Pleuropericardial Effusion (blood and air in cavity around the lungs).

Eating right is imperative for healthy skin. Drinking lots of water and eat five servings of the following antioxidant rich foods as antioxidants protect against age spot and wrinkle causing free radicals.

Phyto-estrogen can help to balance hormones, and are found in: soy, vegetables, whole grains, fruits, flax seeds.
Batacarotene helps skin develop and improves skin tone: pumpkin, sweet potato, spinach, carrots, papaya.

Zinc helps soften skin and repair damage: poultry, red meat, whole grains, seeds, nuts, fish, shellfish.

Vitamin C, heals blemishes and produces a glow: papaya, strawberries, kiwi, blueberries, broccoli, oranges, guava, and blackcurrants.

Selenium, protects against sun damage like sun spots and skin cancer: Brazil nuts, (4 a day, or fish), eggs, shellfish, tomatoes, wheat germ, & broccoli.

Vitamin E, helps skin grow and stops cell damage: almonds, hazelnuts, sunflower/corn oil, avocado, pine nuts.

Essential fatty acids which can’t be made by the body (omega 3 & 6) found in oily fish walnuts, and seed oil (linseed, flax, and rapeseed). These are anti-inflammatory.

Exercise is also important in maintaining healthy skin. As skin ages the signaling protein Interleukin 15 (IL-15) slows down.  The result is skin cells breaking down at a faster rate.  Exercise increases iIL-15 production, slowing this process and helping to maintain the skins health. Exercise increases blood flow to the skin, which helps move the nutritional building blocks of collagen to the cells in need of it.  Exercise also increases cellular energy levels, making them work better (10).  Weight training or the use of resistance bands helps maintain muscle mass, which in turn more efficiently process blood sugar, associated with inflammation (redness).

References:

  1. Ganceviciene, R., Liakou, A.L., Theodoridis, A., Makrantonaki, E., & Zouboulis, C.C. (2012). Skin anti- aging strategies. Dermato-Endocrinology, 4, (3), 308-319.
  2. Lewin, J. Eat your way to fabulous skin. Published on BBC Good Food, accessed:                www.bbcgoodfood.com/howto/guide/eat-your-way-faboulous-skin
  3. Sangeeta, & Sharma, A., (2014). The amazing pharmacological properties of Haridra-A short review. Ayushdhara, an International Journal of Research in Ayush and Allied Systems, 1, 27-31.
  4. WebMD website. Webpage:Thyroid may cause sexual problems.   retrieved from:                 www.webmd.com/women/news/20020321/thyroid-may-cause-sexual-problems
  5. Mayo clinic website. Webpage: Drugs and Supplements, DHEA. Retrieved on April 13, 2016. Retrieved from: Mayoclinic.org /drugs-supplements/dhea/evidence/hrb_20059173

6 University of Maryland Medical Centre website, webpage: Vitamin H (Biotin).  Retrieved from:                 www.umm.edu/health/medical/altmed/supplement/vitamin-h-biotin

7   Durable Health website, webpage:  Biotin side effects, is biotin safe, 5000 mcg pills, skin, weight gain               & period. Retrieved from:  www.durablehealth.net/biotin-side-effects-biotin-safe-5000mcg-pill-    skin-period/

8   Living Strong website, webpage:  Side effects of Biotin 5000 mg, posted by A.M. Tacon, Aug 16, 2013.                 Retrieved from www.livingstrong.com/article/353466-side-effects-of-biotin-5000-mg/

9 Crane, J.D., MacNeil, L.G., Lally, J.S., Ford, R.J., Brar, I.K., Kemp, B.E., Raha, S., Steinberge, G.R., & Tamopolsky, M.A., (2015).  Exercise-stimulated interleukin-15 is controlled by AMPK and regulates skin metabolism and aging.  Aging Cell 14 (4) 625-634.  Doi:  10.1111/acel.12341.

10 Natrualpathic Currents Website.   Webpage: Antiaging-a natrual approach to youthful skin by Kempinska, N., Nd.  Accessed:  http://www.naturopathiccurrents.com/article/antiaging#part4

PLEASE NOTE: THIS INFORMATION IS PROVIDED FOR INFORMATIONAL PURPOSES ONLY. TALK TO A QUALIFIED HEALTH PROFESSIONAL BEFORE MAKING ANY DIET OR LIFESTYLE CHANGES.

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